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目的 总结手术矫治 3个月以内婴儿室间隔缺损的效果。方法 1999年 6月~ 2 0 0 1年 11月手术治疗 2 0例先天性心脏病室间隔缺损伴肺动脉高压婴儿 ,其中男 12例 ,女 8例。年龄 34~ 10 4d ,平均 (74.6 5± 9.70 )d。体重 3.35~ 7.0 0kg ,平均 (4 .93± 0 .94)kg。室间隔缺损均为单发 ,其中膜周型 16例 ,肺动脉瓣下 4例。 2例合并动脉导管未闭 (PDA) ,1例合并房间隔缺损 (ASD)、PDA及主动脉缩窄 (CoA) ,1例合并ASD和右冠状动脉 右室瘘。所有患儿均在全麻低温体外循环下行Ⅰ期矫治术。结果 术后早期 (30d内 )死亡 1例 (病死率 5 .0 % )。发生并发症者 10例 ,发生率5 0 .0 %。肺不张 4例 ,低心排 2例 ,心律失常 2例 ,肺炎 2例 ,胸腔积液 1例 ,渗漏综合征 1例 ,经治疗后痊愈出院。结论 反复肺炎和肺动脉高压的室间隔缺损婴儿应尽早手术根治。术后应注重呼吸道的管理和出入量的调整
Objective To summarize the effect of surgical treatment of infantile ventricular septal defect within 3 months. Methods From June 1999 to November 2001, 20 infants with congenital heart disease and ventricular hypertrophy were treated by surgery, including 12 males and 8 females. Age 34 ~ 104d, average (74.65 ± 9.70) d. Weight 3.35 ~ 7.0 0kg, average (4.93 ± 0.94) kg. Ventricular septal defect were single, including 16 cases of perilymph, pulmonary valve 4 cases. Two patients with patent ductus arteriosus (PDA), one patient with atrial septal defect (ASD), PDA and aortic constriction (CoA) and one patient with ASD and right ventricular fistula. All children underwent general anesthesia with hypothermic cardiopulmonary bypass Ⅰ correction. Results In the early postoperative period (within 30d), 1 patient died (mortality rate was 5.0%). Complications occurred in 10 cases, the incidence of 50.0%. Atelectasis in 4 cases, low cardiac output in 2 cases, arrhythmia in 2 cases, pneumonia in 2 cases, pleural effusion in 1 case, leakage syndrome in 1 case, after treatment cured. Conclusion Infants with ventricular septal defect after repeated pneumonia and pulmonary hypertension should be treated by radical operation as soon as possible. After surgery should pay attention to respiratory tract management and the adjustment of access